The Man With the Plan

It was a crazy, stressful time in my life that I prefer not to relive.

I still cringe and change the channel when Say Yes to the Dress comes on…

And so, back when I worked at the salon, I had this old, crazy Eastern European boss who was both the nicest, warmest, most generous, and also the most infuriating, make-you-want-to-slice-your-wrists, batshit-craziest woman you’ve ever had the pleasure of meeting.

Oy. Even typing that stresses me out.

Aaaaanyway, back to the story: BatshitCrazyCroatianLady used to say the funniest thing when she was tired. Not just regular tired, but tired like you have just been given way too much information to process and need a mental break.

“My brain feels like mashed potato.”

You know what, psycho? I totally feel ya on the mashed-potato-brain.

As you know, I met with my new RE, Dr. K, yesterday.

He was so many things…

Confident without being arrogant.

Knowledgeable without talking down to me.

Communicative without being smug.

Just. Plain. Awesome.

I liked him immediately. He sat me down and the first thing he said after shaking my hand was, “Well, do you have any questions for me, or should we jump right into the things I found very interesting in the records of your previous treatment cycles?”

Uhh. Yeah! That! Let’s talk about that!

First, he wanted to talk about sperm. I was concerned this was going to be one of those speeches about how babies are made, but thankfully it wasn’t.

(I’m still a little gun-shy after the time I approached my first Ob-Gyn with my concerns about how long it took to get pregnant… To recap, she explained to me that oral sex did not make babies, told me to stop charting because that was nonsense, and told me to have more sex and come back in a year. Yeah.)

Apparently, the semen analysis we had done back in February at the start of the clinical study showed great numbers in volume, count, and motility. The morphology, however, was bleak, and no one ever felt the need to mention this WHY??

I’m still a little miffed about that, buuuuuut, moving on…

The husband’s strict morphology level was 2%.

If you’re not familiar with the term (I know I wasn’t!), that basically means that of all of the swimmers in that sample, only 2% were formed the way good sperm are supposed to be.

That means that 98% of the swimmers in that sample looked pretty much like Sloth from The Goonies.

Nice, huh?

Dr. K was a bit surprised that Iwas surprised by this news, especially since we’ve been through so many cycles and this has never come up in all this time!

He assured me though, that after consulting the notes on the particular type of shape irregularity the husband’s sample showed, he felt that things could be worse. These swimmers can swim, there are lots and lots of them, and even the funny-looking ones are perfectly capable of fertilizing a good egg.

I was soundly made aware of the issue, and put on notice that if things didn’t improve in my end of the arena, IVF will be an extremely close-at-hand option.

Which leads me into his second concern: My FSH levels.

I guess no one ever mentioned this to me either, but my FSH has been rather low on more than one occasion recently. Dr. K thinks that this is more likely the reason I’m not getting pregnant, or maybe a combination of Sloth-sperm and sad eggs not making the boom-boom as required.

He feels that if we can increase my FSH, that we will get nicer eggs that mature better, release fully, and are better able to be fertilized by whatever sperm comes along. He also feels that if I can release prettier, healthier, more mature eggs, then my progesterone levels will be all pretty too. He is not a fan of prescribing progesterone just for the heck of it, and would rather get to the root of the issue.

At this point in the appointment, I’m both in fear and in awe of this man who has brought all of these things to light in his tiny office in the middle of a giant hospital.

He asked me about my diet and exercise, and I informed him of my recent weight-gain and workout plan. He was thrilled to hear that I’ve gained 20 pounds in the past year, and I swear to you he did the creepy Mr. Burns-from-The-Simpsons thing where he steepled his fingers and said “Eeeeeexcellent.”

He was weirdly happy about that. I mean, so is the husband, but it’s mostly because he likes the way my fun bits jiggle now, not because he cares about my estrogen levels.

So, after all of that discussion, Dr. K laid out his plan:

Start Femara immediately. Liiiiiike, today. For five days.

Start FSH as soon as I finish the Femara. Five days on this too.

Come back on CD12 for an ultrasound. Just one. If the eggs are going to respond appropriately, they will have done so by this point.

If my eggs look sparkly and pretty and ripe for the pickin’, we can make the call at that point to either try the good old fashioned at-home method of conception, or opt for IUI if we feel so inclined.

If my eggs are still sad, we will move forward and adjust the meds accordingly for the next cycle.

He will not subject me to multiple IUIs, as he feels that they are an unnecessary expense.

If no progress is being made within a couple of cycles, we will move quickly and aggressively toward options that will yield better results.

We will not waste time, resources, or emotions on this process.

Constant forward motion is part of my treatment plan.

Whew.

So…

I still have questions. I am still a little anxious about this whole process. I am still a little stunned that I am only just now learning that I may not be quite so “unexplained” after all. I am in a bit of a whirlwind with how fast this is all moving…

But…

I kinda love this man.

He is the man with the plan, and I fully expect to be knocked up this year. 🙂

SERIOUSLY. I get that with the clinical study they only looked at certain numbers, but it seems like if they tested for strict morphology, they should have at least MENTIONED that scary-low number to me!

I’m glad you’re getting to the root of the problem, but I can’t believe no one ever told you! Morphology is confusing. I was told by my uncle, a urologist, that strict morphology is nonsense and that WHO guidelines are good enough. He said there is a huge disagreement in the medical community over the two. I was told by the RE that strict morphology was the most important parameter in testing sperm. SOOO maybe whoever you were with didn’t think it was important? Either way, I’m glad you have a plan and that you like the new RE!!

It IS confusing! My old RE, before the clinical study, did not test strict morphology, and the WHO looked good at that point. The clinical doctors did the strict testing, but apparently didn’t consider those numbers…? So weird.

New doc did say that he doesn’t put 100% of stock in any of those numbers, and that he doesn’t think we have such a bad problem. He still thinks we may be able to get pregnant without forcing the good sperm to play nice, so that’s good to hear. 🙂

I have been following your blog for awhile now and I saw your post today and had to comment. My husband and I struggled with infertility for 3 1/2 years. We did everything, all the crazy drugs and iui’s. Finally we went to a new RE who had us do another SA and found that hubby’s morphology was only 2%. He immediately suggested ivf. We were scared of that word and had a lot of resistance, but our RE told us that our chances of pregnancy would be 75%. We decided to stop messing around and go for it. First attempt and I am finally knocked up, with twins! It is scary to have to think about going there, but if you are sick of messing around…. Go for it!!! I wish you luck, send you baby dust and can’t wait to read your pregnant post!!

I’m equal parts happy and pissed off on your behalf. Why would anyone keep that kind of information from you?! Yet another example of doctors keeping patients in the dark because they think we are on some kind of need-to-know basis and we apparently need to know nothing. I also had a similar experience with my first OB. I might be a little touchy about this subject. However, your new RE sounds fabulous, and it’s wonderful that you have a plan now! Best of luck!!

Hurray for a plan! I’m so excited for your next steps. Also pissed that no one ever mentioned anything questionable about the SA results. Not cool, even if that measure isn’t always agreed upon as reliable. I really hope you have results ASAP! I’m keeping my fingers crossed for you as always.

Apparently NOT! I was so dumbfounded when she was explaining this to me, she probably thought I was struck wordless with the new information, when in fact I was without words because of her complete idiocy.

Gah. Some people.

Oh, and I have decided to name all of my eggs “Chunk”. Because, you know, “Sloth loves Chunk!”.

Right?! It seems craaaaazy to me that some of these doctors are making so much money, and putting forth so little effort to actually search out what their patients need. Maybe tiny little practices are really the way to go…

Um, whiskey tango foxtrot?! Why were those levels and numbers not brought to your attention? It’s not like you were trying to make a baby or anything. I’m SUPER glad this new RE has a head on his shoulders and that he has given you a bright outlook! 🙂 Sending you lots of good luck!

Just catching up! That is awesome about the new doc. But holy crap – that is my fear – that there is this information that is *really pivotal* that doctors are missing. Anyhow, I am glad he brought those issues to light and hopefully you three will be making a baby together soon!

This Is My Deal...

I'm Tracy. I'm a thirty-something, happily married miscarriage survivor, who tried just about everything possible to conceive for over five years, is currently parenting our miracle baby girl, and blogging about the hilarity of it all.

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A safe space where I discuss the racing thoughts in my head, personal struggles, and day-to-day activities while struggling with mental health and mood disorder issues. My personal goal is to reduce the stigma that comes with mental health and mood disorders, by talking more about it.